Sutures and Stitches

  • General Information:
    • What is a suture?
      • Any strand of material used to ligate blood vessels or to approximate tissues
    • How are sutures sized?
      • By diameter;:
        • Stated as a number of 0’s:
          • The higher the number of 0’s, the smaller the diameter:
            • For example a 2-0 suture has larger diameter than 5-0 suture
    • Which is thicker, 1-0 suture or 3-0 suture?
      • 1-0 suture
  • Classification:
    • What are the two most basic suture types?
      • Absorbable and non-absorbable
    • What is an absorbable suture?
      • Suture that is completely broken down by the body:
        • Dissolving suture
    • What is a nonabsorbable suture?
      • Suture is not broken down:
        • Permanent suture
  • Sutures:
    • Catgut:
      • What are “catgut” sutures made of?
        • Purified collagen fibers from the intestines of healthy cows or sheep
      • What are the two types of gut sutures?
        • Plain and chromic
      • What is the difference between plain and chromic gut?
        • Chromic gut is treated with chromium salts (chromium trioxide):
          • Which results in more collagen cross-links:
            • Making the suture more resistant to breakdown by the body
  • Vicryl® Suture
    • What is it?
      • Absorbable, braided, and multi-filamentous copolymer of lactide and glycoside
    • How long does it retain its strength?
      • 60% at 2 weeks
      • 8% at 4 weeks
    • Should you ever use PURPLE-colored Vicryl® for skin closure?
      • No:
        • It may cause purple tattooing
  • PDS®
    • What is it?
      • Absorbable, monofilament polymer of polydioxanone:
        • Absorbable fishing line
    • How long does it maintain its tensile strength?
      • 70% to 74% at 2 weeks
      • 50% to 58% at 4 weeks
      • 25% to 41% at 6 weeks
    • How long does it take to complete absorption?
      • 180 days (6 months)
  • What is silk?
    • Braided protein filaments:
      • Spun by the silkworm larva:
        • Known as a nonabsorbable suture
  • What is Prolene®?
    • Non-absorbable suture:
      • Used for vascular anastomoses, hernias, abdominal fascial closure
  • What is nylon?
    • Non-absorbable “fishing line”
  • What is monocryl?
    • Absorbable monofilament
  • What kind of suture should be used for the biliary tract or the urinary tract
    • ABSORBABLE:
      • Otherwise the suture will end up as a nidus for stone formation

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